Third Party Administrators
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    TPA Drug Manufacturer
    What bank information will be used for receiving payments?
    For receivables (i.e. ACH Deposits), the bank information listed on the EFT form you provided to TPA Operations will be used. Note: This form must be completed even if you will be using the same account for both making and receiving payments. To complete this form, visit – EFT Information- EFT Online Form (For Manufacturer Use Only) or EFT Information- EFT Online Form (For Sponsor Use Only), and complete the form in its entirety. The completed form should be submitted online, and a printed signed copy must be mailed to the TPA at the address listed on the form. If you’re unsure if you have the correct EFT on file, please contact TPA Operations at 1-877-534-2772, option 1.


    last updated on 08/17/2015